medigraphic.com
Instituto Nacional de Salud Pública

2018, Number 2

<< Back Next >>

salud publica mex 2018; 60 (2)

Contexts and challenges for mental health care at the first level. A socioecological approach

Berenzon-Gorn S, Saavedra-Solano N, Galván-Reyes J

Language: Spanish
References: 19
Page: 184-191
PDF size: 385.86 Kb.


ABSTRACT

Objective. To analyze the current status of mental health care through a socioecological analysis, based on the perceptions of health center (HC) staff and users in Mexico City (CDMX). Materials and methods. Descriptive exploratory study of mixed methods (QUALI→ QUANT). During the qualitative phase, staff at 19 centers located in three Mexico City boroughs were interviewed and during the quantitative phase, a questionnaire was applied to patients. Results. The influence and interdependence of the various factors impacting mental health (MH) care were identified. Health personnel and patients mentioned limited resources, which impact service quality, public MH policies that are not always implemented in practice and a care model that does not make it possible to delve into emotional problems. Conclusions. Improving MH care at the primary care level requires reflective work from a variety of perspectives.


REFERENCES

  1. Organización Mundial de la Salud. Plan de acción integral sobre SM 2013-2020. Suiza: Organización Mundial de la Salud, 2013:50.

  2. Organización Mundial de la Salud. Informe sobre la salud en el mundo 2001: Salud mental: nuevos conocimientos, nuevas esperanzas. Suiza: Organización Mundial de la Salud, 2001:169.

  3. Thielke S, Vannoy S, Unützer J. Integrating mental health and primary care. Primary care: Clinics in office practice. 2007;34(3):571-92.

  4. Hewlett E, Moran V. Making Mental Health Count: The Social and Economic Costs of Neglecting Mental Health Care. Paris: OECD Health Policy Studies, OECD Publishing, 2014:246.

  5. Clarke G, Lynch F, Spofford M, DeBar L. Trends influencing future delivery of mental health services in large healthcare systems. Clinical Psychology: Science and Practice. 2006;13(3):287-92.

  6. Telford R, Hutchinson A, Jones R, Rix S, Howe A. Obstacles to effective treatment of depression: a general practice perspective. Family Practice. 2002;19(1):45-52.

  7. Vargas B, Villamil V, Romero J. Los modelos de atención primaria en salud mental: el caso de México. Atención Primaria. 2012;44(7):441-2.

  8. Madrigal A. Fortalecimiento de la salud mental en México: recomendaciones para una psiquiatría comunitaria. Salud Mental. 2016;39(4):235-7.

  9. Saavedra N, Berenzon S, Galván J. Salud mental y atención primaria en México. Posibilidades y retos. Atención Primaria. 2016;48(4):258-64.

  10. Martinez W, Galván J, Saavedra N, Berenzon S. Barriers to integrating mental health services in community-based primary care settings in Mexico City: a qualitative analysis. Psychiatric Services. 2017;68(5):497-502.

  11. Berenzon S, Saavedra N, Medina-Mora ME, Aparicio V, Galván J. Evaluación del sistema de salud mental en México: ¿hacia dónde encaminar la atención? Rev Panam Salud Pública. 2013;33(4):252-8.

  12. Gaceta Oficial del Distrito Federal. Ley de Salud Mental del Distrito Federal. [Internet]. Distrito Federal; 2011 [citado marzo 3, 2017]. Disponible en: http://www.anmb.mx/pdf2014/breviario_leydesaludmental.pdf

  13. Bronfenbrenner U. Ecology of the family as a context for human development: Research perspectives. Developmental Psychology. 1986;22(6):723-42.

  14. McLeroy K, Bibeau D, Steckler A, Glanz K. An ecological perspective on health promotion programs. Health Education Quarterly. 1988;15(4):351-77.

  15. Sword W. A socio-ecological approach to understanding barriers to prenatal care for women of low income. J Adv Nurs. 1999;29:1170-7.

  16. Creswell J, Plano V, Gutmann M, Hanson W. Advanced mixed methods research designs. Handbook of mixed methods in social and behavioral research. Thousand Oaks, CA: Sage, 2003:209-40.

  17. Kvale S. Las entrevistas en investigación cualitativa. Madrid: Ediciones Morata, 2011:196.

  18. Menéndez E. Modelos de atención de los padecimientos: de exclusiones teóricas y articulaciones prácticas. Ciência & Saúde Coletiva. 2003;8(1):185-207.

  19. Organización Panamericana de la Salud. Fortaleciendo la salud mental en nuestras comunidades. Lima: OPS, 2012:58.




2020     |     www.medigraphic.com